Individual
DR. WILEY LIPSCOMB PURCELL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.M.D
Contact information
Practice address
3636 WHEELER RD, AUGUSTA, GA 30909-6626
(706) 869-9117
Mailing address
3636 WHEELER RD, AUGUSTA, GA 30909-6626
(706) 869-9117
Taxonomy
Speciality
Code
Description
License number
State
1223E0200X
Endodontics
Primary
DN015381
GA
1223G0001X
General Practice Dentistry
DN015381
GA
390200000X
Student in an Organized Health Care Education/Training Program
DN015381
GA
Other
Enumeration date
06/02/2016
Last updated
07/01/2020
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